TravelNurseSource
Travel Nurse RN - Utilization Review - $2,386 per week in Honolulu, HI
TravelNurseSource, Honolulu, Hawaii, United States, 96814
Travel Nurse RN – Utilization Review
Location:
Honolulu, HI
Agency:
Magnet Medical
Pay:
$2,386 per week
Shift:
3 days x 12 hours
Contract:
13 weeks
Start Date:
1/5/2026
About The Position TravelNurseSource is working with Magnet Medical to find a qualified Utilization Review RN. The RN ensures healthcare services are medically necessary, appropriate, and efficient, working with providers, insurers, and patients to review records and determine care level. The role requires strong clinical knowledge, understanding of insurance guidelines, and hospital operations.
Key Responsibilities
Review patient medical records and clinical data to assess appropriateness of care and necessity of continued hospitalization.
Assess the medical necessity of procedures and tests against guidelines such as InterQual or Milliman.
Evaluate care for appropriateness, efficiency, and compliance with clinical evidence.
Collaborate with physicians, case managers, and other professionals to ensure cost‑effective care plans.
Communicate with healthcare teams about discrepancies or concerns regarding utilization of resources.
Provide recommendations or alternative care options to improve outcomes.
Work with insurance companies, managed care organizations, and payers to review coverage, authorization, and reimbursement.
Submit documentation to support medical necessity determinations and secure prior authorization.
Resolve denied claims or documentation issues to ensure coverage.
Monitor length of stay, identify discharge delays, and assist discharge planning.
Collaborate on discharge plans with case management and interdisciplinary teams.
Ensure compliance with regulations (TJC, CMS, etc.) and audit utilization processes.
Maintain knowledge of regulations, coding guidelines, and payer policies.
Document findings and prepare utilization reports for management.
Perform case reviews to align care level with guidelines.
Educate staff and providers about medical necessity criteria and compliance.
Participate in continuing education related to UR, case management, or quality improvement.
About Magnet Medical Magnet Medical, with 30 years of experience, provides staffing to hospitals and skilled nursing facilities across all 50 states. We aim to deliver quality service and support to care providers.
Modalities We Staff
Registered Nurses
LPN/LVN
PT/PAs
OT/COTAs
SLP
Surgical Techs
Sterile Processing Techs
Requirements
BLS
Seniority Level Not Applicable
Employment Type Full‑time
Job Function Health Care Provider
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Honolulu, HI
Agency:
Magnet Medical
Pay:
$2,386 per week
Shift:
3 days x 12 hours
Contract:
13 weeks
Start Date:
1/5/2026
About The Position TravelNurseSource is working with Magnet Medical to find a qualified Utilization Review RN. The RN ensures healthcare services are medically necessary, appropriate, and efficient, working with providers, insurers, and patients to review records and determine care level. The role requires strong clinical knowledge, understanding of insurance guidelines, and hospital operations.
Key Responsibilities
Review patient medical records and clinical data to assess appropriateness of care and necessity of continued hospitalization.
Assess the medical necessity of procedures and tests against guidelines such as InterQual or Milliman.
Evaluate care for appropriateness, efficiency, and compliance with clinical evidence.
Collaborate with physicians, case managers, and other professionals to ensure cost‑effective care plans.
Communicate with healthcare teams about discrepancies or concerns regarding utilization of resources.
Provide recommendations or alternative care options to improve outcomes.
Work with insurance companies, managed care organizations, and payers to review coverage, authorization, and reimbursement.
Submit documentation to support medical necessity determinations and secure prior authorization.
Resolve denied claims or documentation issues to ensure coverage.
Monitor length of stay, identify discharge delays, and assist discharge planning.
Collaborate on discharge plans with case management and interdisciplinary teams.
Ensure compliance with regulations (TJC, CMS, etc.) and audit utilization processes.
Maintain knowledge of regulations, coding guidelines, and payer policies.
Document findings and prepare utilization reports for management.
Perform case reviews to align care level with guidelines.
Educate staff and providers about medical necessity criteria and compliance.
Participate in continuing education related to UR, case management, or quality improvement.
About Magnet Medical Magnet Medical, with 30 years of experience, provides staffing to hospitals and skilled nursing facilities across all 50 states. We aim to deliver quality service and support to care providers.
Modalities We Staff
Registered Nurses
LPN/LVN
PT/PAs
OT/COTAs
SLP
Surgical Techs
Sterile Processing Techs
Requirements
BLS
Seniority Level Not Applicable
Employment Type Full‑time
Job Function Health Care Provider
#J-18808-Ljbffr